Remnant Gastric Perforation at a Patient With Colon Interposition: A Rare Case

Varlik Erol, Levent Ugurlu, Mutlu Unver, Safak Ozturk, Gokhan Akbulut, Cengiz Aydin

Abstract


The purpose of performing surgical treatment after benign or maligned pathologies of the esophagus is to provide the continuity of the intestinal system. Especially after caustic esophagus injuries mostly colon interposition is performed to provide continuity. In this case study was made to determine actions to be taken for follow-up and as a treatment method for patients developing remnant perforation at the stomach after a colon interposition. A 53-year-old female patient came with complaint of abdominal pain for 2 days. Anamnesis showed that left colon interposition was performed because of esophagus stricture development after she drank caustic substance about 10 years ago. After acute abdominal findings during the physical examination, a direct abdominal graphy was made while standing and the X-ray of the lungs showed free air in the inner abdomen, together with findings of perforation at the computed tomography (CT), and it was decided to perform an urgent surgical intervention. During the exploration a perforation of approximately 1 cm was determined on the front side of the remnant gastric antrum. The perforation was sutured primarily with 2/0 silk. Postoperative on the fourth day, the oral intake of the patient was opened which is tolerated and the patient was discharged on day 7 after surgery. If no results are obtained from the endoscopic dilatation methods performed on patients developing stricture after caustic esophagus and stomach injuries, the most appropriate method to provide the continuity of the intestinal system is a left colon interposition, which has got perfect long-term results. Although especially complications of the remnant organ are rarely seen, regarding cases with acute abdominal examination findings besides complications belonging to the colon graft, the remnant organ’s pathologies must be kept in mind and exploration must be performed with caution.




J Med Cases. 2015;6(1):43-45
doi: http://dx.doi.org/10.14740/jmc1998w

Keywords


Colon interposition; Remnant gastric perforation; Treatment

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